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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms

Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
DOI: 10.1136/jim-2021-002230 Published 25 March 2022
Junjie Luo
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Chengmou Wang
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Yongjian Dai
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xin Chen
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xuecheng Tian
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Yi Lin
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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Xinguo Qu
Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
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This article has a correction. Please see:

  • Correction: Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms - December 01, 2022

Abstract

This study aims to evaluate the efficacy and safety of endovascular therapy versus neurosurgical clipping carried out for patients with unruptured middle cerebral artery bifurcation aneurysms (MCABAs). Patients diagnosed with MCABAs were enrolled in this prospective study according to the inclusion and exclusion standard. Enrolled patients were divided into a study group (endovascular therapy) and a control group (neurosurgical clipping), with 65 cases in each group. In terms of efficacy, we found that the proportion of Glasgow Outcome Scale (GOS) grade 1 after treatment in the study group was significantly higher than in the control group (p<0.001), while the proportion of GOS grades 2, 3, and 4 after treatment was significantly lower in the study group than in the control group (p<0.05). The postoperative brain injury indicators neuron-specific enolase and S100β in the study group were significantly lower than in the control group (p<0.001), and the postoperative life activity score of patients in the study group was significantly higher than in the control group (p<0.001). In terms of safety, the postoperative hospital stay of patients in the study group was significantly shorter than in the control group (p<0.001), and the incidence rate of postoperative pulmonary and intracranial infections in the study group was significantly lower than in the control group (p<0.05). Endovascular therapy for patients with unruptured MCABAs may be effective in improving outcomes and has better safety profile compared with neurosurgical clipping, but may increase the risk of postoperative recurrence.

Footnotes

  • JL and CW contributed equally.

  • Contributors Concept and design of the work: JL, CW. Acquisition: JL, CW, YD, XC, XT, YL, XQ. Analysis: JL, CW, YD, XC, XT, YL, XQ. Drafting the paper: JL, CW. Revising the paper: XQ. Guarantor: XQ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Data availability statement

Data sharing not applicable as no datasets generated and/or analyzed for this study.

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Vol 70 Issue 8 Table of Contents
Journal of Investigative Medicine: 70 (8)
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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Mar 2022, jim-2021-002230; DOI: 10.1136/jim-2021-002230

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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Mar 2022, jim-2021-002230; DOI: 10.1136/jim-2021-002230
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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
Junjie Luo, Chengmou Wang, Yongjian Dai, Xin Chen, Xuecheng Tian, Yi Lin, Xinguo Qu
Journal of Investigative Medicine Mar 2022, jim-2021-002230; DOI: 10.1136/jim-2021-002230
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